Basic Information
| Provider Information | |||||||||
| NPI: | 1851578702 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOINER | ||||||||
| FirstName: | SKY | ||||||||
| MiddleName: | EVA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | R.D., L.D., C.D.E | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5000 COUNTRY CLUB DR | ||||||||
| Address2: | |||||||||
| City: | MERIDIAN | ||||||||
| State: | MS | ||||||||
| PostalCode: | 393051843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6015276028 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2124 14TH ST | ||||||||
| Address2: | |||||||||
| City: | MERIDIAN | ||||||||
| State: | MS | ||||||||
| PostalCode: | 393014040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6015536000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2008 | ||||||||
| LastUpdateDate: | 10/22/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | D0351 | MS | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.